93 Decision Citation: BVA 93-05385
Y93
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
DOCKET NO. 92-17 245 ) DATE
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THE ISSUE
Entitlement to an increased rating for subacromial bursitis
on the right, currently evaluated as 10 percent disabling.
Entitlement to an increased rating for subacromial bursitis
on the left, currently evaluated as 10 percent disabling.
REPRESENTATION
Appellant represented by: Disabled American Veterans
ATTORNEY FOR THE BOARD
M. L. Schwartz, Associate Counsel
INTRODUCTION
This matter came before the Board of Veterans' Appeals
(Board) on appeal from a rating decision of November 5,
1991, from the Montgomery, Alabama, regional office (RO).
The notice of disagreement was received on January 8, 1992.
The statement of the case was issued on January 30, 1992.
The substantive appeal was received on July 31, 1992. The
appeal was received at the Board on September 23, 1992, and
docketed on September 25, 1992. The appellant is
represented by the Disabled American Veterans, to which the
file was referred. That organization prepared additional
written argument for the Board on October 15, 1992.
The veteran had active military service from August 1950 to
February 1971.
The veteran, through his representative, has requested
consideration of a claim for service connection for
rheumatoid arthritis, arguing that it is "inextricably
intertwined" with the issues set forth on the cover page of
this decision. However, service connection for rheumatoid
was denied in a rating action of August 1985, and was not
appealed. Given its procedural status, we find that the
issue of whether new and material evidence has been
submitted to support a claim for service connection for
rheumatoid arthritis, has not been developed for appellate
review, and accordingly, the matter is referred to the RO
for consideration, as appropriate.
Additionally, the veteran, through his representative, has
also raised claims for service connection for gunshot wound
residuals of the left flank and right little finger, the
residuals associated with the passing of a urethral stone,
and cardiovascular problems. None of these matters has been
considered by the RO, and they are hereby referred to that
office for further development, as appropriate.
After review, it is also our judgment that the record on the
certified issues may not yet be ready for a final appellate
decision on the merits of entitlement to the benefits being
sought on appeal.
REMAND
The veteran argues that he was recently hospitalized and
treated for bursitis and arthritis, arguing that this is
evidence of increased disability with respect to his
service-connected disorder, asserting that an increased
rating is warranted.
The report of the veteran's hospitalization at a Department
of Veterans Affairs (VA) facility in August and September
1991, reveals that the veteran presented with complaints of
pains in multiple joints, including both shoulders. It was
noted that both shoulders had a decreased range of motion,
not further specified, and that each was tender and painful
to palpation, but with no swelling. The admitting diagnosis
was rheumatoid arthritis; the discharge diagnosis was
bursitis of both shoulders.
Bursitis is evaluated according to Diagnostic Code 5019,
which provides that compensation is to be provided according
to the degree of limitation of motion of the body part
affected. In this case, the most current evaluation
indicates only that there is a decrease in the range of
motion in each shoulder, not further described, so that the
disorder in issue cannot be adequately evaluated under
Diagnostic Codes 5200-5203 for limitation of motion of the
shoulder. Additionally, the veteran has not been afforded a
special orthopedic examination for rating purposes since
1985.
The VA has a duty to assist the veteran in the development
of his claim. 38 U.S.C.A. § 5107(a) (West 1991). The
United States Court of Veterans Appeals has interpreted this
duty to include providing the veteran with complete and
adequate VA examinations, so that adequate reasons and bases
may be stated in support of the resulting adjudication.
Gilbert v. Derwinski, 1 Vet.App. 49 (1990); Littke v.
Derwinski, 1 Vet.App. 90 (1990). Additionally, the Court in
Schafrath v. Derwinski, 1 Vet.App. 589 (1991), has placed a
great deal of emphasis on the regulatory requirements
specifying that a historical review of the disorder in issue
must be made before an adequate assessment regarding the
current status of the disorder may be determined. 38 C.F.R.
§§ 4.1, 4.1, 4.41, 4.42. Generally, the examiner's role in
observing these requirements is found in the Physician's
Guide for Disability Evaluation Examination (IB 11-56),
Sections 1.12, 1.13, and 1.14.
Therefore, this case is REMANDED for the following action:
The RO should schedule the veteran for a
special orthopedic examination, which
should include a full description of the
active and passive ranges of motion in
each of the veteran's shoulders. All
indicated diagnostic testing should be
carried out at the discretion of the
examiner. Symptoms and manifestations
attributable to bursitis, rheumatoid
arthritis, and degenerative arthritis
should be differentiated to the extent
possible.
This evaluation is to be conducted in
accordance with the Court's directive in
Schafrath, as discussed above, and all
pertinent clinical records are to be made
available to the examiner.
When this development has been completed, the claim should
be reviewed by the RO. If the benefit sought on appeal is
not granted, the veteran and his representative should be
given a supplemental statement of the case with regard to
the additional development and should be afforded an
opportunity to respond.
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
*
C. P. RUSSELL
JACK W. BLASINGAME
(Continued on next page)
*38 U.S.C.A. § 7102(a)(2)(A) (West 1991) permits a Board of
Veterans' Appeals Section, upon direction of the Chairman of
the Board, to proceed with the transaction of business
without awaiting assignment of an additional Member to the
Section when the Section is composed of fewer than three
Members due to absence of a Member, vacancy on the Board or
inability of the Member assigned to the Section to serve on
the panel. The Chairman has directed that the Section
proceed with this decision without awaiting the assignment
of a third Member.
Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the
Board of Veterans' Appeals is appealable to the United
States Court of Veterans Appeals. This remand is in the
nature of a preliminary order and does not constitute a
decision of the Board on the merits of your appeal.